Virtual Reality for Anxiety Reduction in Patients Undergoing Non-Surgical Cardiac Procedures: A Narrative Review

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Published Oct 11, 2026
https://doi.org/10.62438/tunismed.v104i09.5744
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Vol. 104 No. 09 (2026): Tunis Med Sept 2026

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Siwar Belhaj Salem
Department of Family Medicine, Faculty of Medicine of Monastir, Monastir, Tunisia.
Sarah Suwal
Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
Sahira Shrestha
Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
Linh Huynh
Kansas Health Science Center, Wichita, United States
Sara Javid
Department of internal medicine, A.R Hospital, Ramanathapuram, India
Syed Muhammad Hassan
Karachi Medical and Dental College, Karachi, Pakistan
Jayashree Ravikumar
Department of Internal Medicine, Sri Varadhar Consultation Clinic, Chennai, India
Ariba Furqan
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Muhammad Ali Muzammil
Dow University of Health Sciences, Karachi, Pakistan

Abstract

Invasive cardiac procedures are a source of anxiety and discomfort for patients, often impacting their physical and mental wellbeing. While medications remain the standard care for anxiety management in these patients, numerous non-pharmacological alternatives like virtual reality have also been adopted to help manage the resulting distress. Virtual reality constitutes a novel technology that may help reduce the patients’ periprocedural anxiety and pain by providing distraction and relaxation as well as education about the procedures. Thus, we aimed to investigate the effectiveness of virtual reality in anxiety management during non-surgical cardiac procedures, including coronary angiography, cardiac catheterisation, catheter ablation for cardiac arrhythmias, and transcatheter valve implantation. We conducted a narrative review using the PubMed database that included 17 studies. After an in-depth analysis of these studies, we concluded that virtual reality is an efficient tool for increasing patients’ preoperative preparedness and education, lowering anxiety levels during the procedure and potentially reducing post- procedural stress. This review also highlights the limitations of the studies and future areas of research, illuminating the need for further studies and standard guidelines to address more profoundly the application of this technology in daily cardiac procedures.

Keywords:

Virtual reality, Anxiety, Cardiology, Cardiovascular disease, Cardiac catheterization, Angioplasty

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References

  1. Micheluzzi V, Burrai F, Casula M, Serra G, Shadi Al Omary, Pierluigi Merella, et al. Effectiveness of virtual reality on pain and anxiety in
  2. patients undergoing cardiac procedures: A systematic review and meta-analysis of randomized controlled trials. Current Problems in
  3. Cardiology. 2024 May 1;49 (5):102532–2.
  4. Protogerou C, Fleeman N, Dwan K, Richardson M, Dundar Y, Hagger MS. Moderators of the effect of psychological interventions on
  5. depression and anxiety in cardiac surgery patients: A systematic review and meta-analysis. Behaviour Research and Therapy. 2015
  6. Oct;73:151–64.
  7. Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety Disorders and Cardiovascular Disease. Current Psychiatry Reports
  8. [Internet]. 2016 Sep 26;18 (11). Available from: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC5149447/
  9. Delewi R, Vlastra W, Rohling WJ, Wagenaar TC, Zwemstra M, Meesterman MG, et al. Anxiety levels of patients undergoing
  10. coronary procedures in the catheterization laboratory. International Journal of Cardiology. 2017 Feb;228:926–30.
  11. Rousseaux F, Faymonville ME, Nyssen AS, Dardenne N, Ledoux D, Massion PB, et al. Can hypnosis and virtual reality reduce anxiety,
  12. pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial. Trials. 2020 Apr 15;21 (1).
  13. Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO. The use of virtual reality technology in the treatment of anxiety and other
  14. psychiatric disorders. Harvard Review of Psychiatry. 2017;25 (3):103–13.
  15. Bashir Z, Misquith C, Has P, Bukhari S. Effectiveness of virtual reality on anxiety and pain management in patients undergoing cardiac
  16. procedures: a protocol for systematic review and meta-analysis. Open Heart [Internet]. 2023 Jun 1;10 (1):e002305. Available from:
  17. https://pubmed.ncbi.nlm.nih.gov/37399363/
  18. Keshvari M, Yeganeh MR, Paryad E, Roushan ZA, Pouralizadeh M. The effect of virtual reality distraction on reducing patients’ anxiety before coronary angiography: a randomized clinical trial study. The Egyptian Heart Journal. 2021 Nov 4;73 (1).
  19. Larsson CE, Verane Cabassut, Peretout P, Stéphanie Marliere, Vautrin E, Piliero N, et al. Assessment of the Objective Effect of
  20. Virtual Reality for Preoperative Anxiety in Interventional Cardiology. The American Journal of Cardiology. 2023 Aug 21;205:207–13.
  21. Helena E, Tjitske Diederike Groenveld, Garms L, Bonnes JL, Harry van Goor, Damman P. Virtual reality to reduce periprocedural
  22. anxiety during invasive coronary angiography: rationale and design of the VR InCard trial. Open Heart. 2024 Apr 1;11 (1):e002628–8.
  23. Gülcan Bahçecioğlu Turan, Fatma Gür, Zülfünaz Özer, Çağlar Tarkan. Effects of Virtual Reality on Pain, Anxiety, Patient Satisfaction in
  24. Coronary Angiography: A Randomized Trial. Pain management nursing. 2023 Dec 1;
  25. Esma Gökçe, Arslan S. Effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort in catheter
  26. extraction processes for patients undergoing coronary angiography: A randomized controlled trial. International journal of nursing
  27. practice. 2023 Jul 4;29 (6).
  28. Lind A, Majid Ahsan Esfahan, Matthias Totzeck, Fadi Al–Rashid, Haddad A, Dubler S, et al. Virtual reality-assisted distraction during
  29. transcatheter aortic valve implantation under local anaesthesia: A randomised study. International Journal of Cardiology. 2023 Sep
  30. ;387:131130–0.
  31. Hamid Bouraghi, Mohammadpour A, Taleb Khodaveisi, Marjan Ghazisaeedi, Saeedi S, Sahar Familgarosian. Virtual Reality and
  32. Cardiac Diseases: A Systematic Review of Applications and Effects. Journal of Healthcare Engineering [Internet]. 2023 May 30 [cited
  33. Aug 21];2023:1–20. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC10243949/
  34. Paalimäki-Paakki K, Virtanen M, Henner A, Vähänikkilä H, Nieminen MT, Schroderus-Salo T, et al. Effects of a 360° virtual counselling
  35. environment on patient anxiety and CCTA process time: A randomised controlled trial. Radiography. 2022 Oct;
  36. Hermans ANL, Betz K, Verhaert DVM, Dennis, Kristof J.H. Clerx, Debie L, et al. 360° Virtual reality to improve patient education and
  37. reduce anxiety towards atrial fibrillation ablation. Europace. 2023 Feb 4;25 (3):855–62.
  38. Aardoom JJ, Hilt AD, Woudenberg T, Chavannes NH, Atsma DE. A Preoperative Virtual Reality App for Patients Scheduled for
  39. Cardiac Catheterization: Pre–Post Questionnaire Study Examining Feasibility, Usability, and Acceptability. JMIR Cardio. 2022 Feb 22;6
  40. (1):e29473.
  41. Morgan H, Nana M, Phillips D, Gallagher S. The Effect of a VIrtual RealiTy Immersive Experience Upon Anxiety Levels, Procedural
  42. Understanding, and Satisfaction in Patients Undergoing CArdiac CaTHeterization: The VIRTUAL CATH Trial. The Journal of Invasive
  43. Cardiology [Internet]. 2021 Sep 1;33 (9):E681–6. Available from: https://pubmed.ncbi.nlm.nih.gov/34398809/
  44. Chang SL, Kuo MJ, Lin YJ, Chen SA, Yang YY, Cheng HM, et al. Virtual reality informative aids increase residents’ atrial fibrillation ablation procedures-related knowledge and patients’ satisfaction. Journal of the Chinese Medical Association. 2020 Dec 31;84 (1):25–32.
  45. Chang SL, Kuo MJ, Lin YJ, Chen SA, Yang YY, Cheng HM, et al. Virtual reality informative aids increase residents’ atrial fibrillation ablation procedures-related knowledge and patients’ satisfaction. Journal of the Chinese Medical Association. 2020 Dec 31;84 (1):25–32.
  46. Bruno RR, Lin Y, Wolff G, Polzin A, Veulemans V, Klein K, et al. Virtual reality-assisted conscious sedation during transcatheter aortic
  47. valve implantation: a randomised pilot study. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on
  48. Interventional Cardiology of the European Society of Cardiology [Internet]. 2020 Dec 18;16 (12):e1014–20. Available from: https://
  49. pubmed.ncbi.nlm.nih.gov/32597390/
  50. Zablah JE, Rodriguez SA, Leahy R, Morgan GJ. Implementation of virtual reality for patient distraction during diagnostic cardiac
  51. catheterisation. Cardiology in the Young. 2021 Jul 26;1–5.